Contents

1. NEWS

On 12 November 2018, the Global Fund Board approved funding in the amount of $98.0 million for 14 country grants from 13 countries. The Board also approved two multi-country grants valued at $12.5 million and awarded $13.6 million to fund interventions on the Register of Unfunded Quality Demand. This article provides information on the number of funding requests processed, numbers of grants approved, and details of the Grant Approvals Committee’s comments on two of the approved country grants: Montenegro and Niger. Details on comments for four other grants are described in another article in this issue.

2. NEWS

Because progress on malaria is slowing in some of the highest burden countries, WHO has launched a new response targeting the 11 countries that together bear 70% of the world’s malaria burden, 10 of which are in Africa. The response is dubbed “High Burden to High Impact,” and provides a framework for improving the impact of malaria funding and programs – but does not include any new funding.

3. OVERVIEW

The publication in November of the World Health Organization’s 2018 World Malaria Report delivered the bracing message that malaria is, in some regions, on the rise, and that the epidemic is increasingly concentrating in a small number of countries that are also waging other major health and development battles (Ebola among them). This short article points to a small range of responses to the WHO report, from Health Policy Watch,Devex, the Lancet, and the Global Fund itself - a companion piece to the article in this GFO on WHO’s launch of a new malaria ‘response’ to the report’s findings.

4. NEWS

A Guinean NGO contracted by a Global Fund HIV grant Principal Recipient was found to have falsified survey participants and responses, as well as blood test and HIV prevalence data. The implications are far-reaching – the type of survey that was falsified (an Integrated Biological and Behavioural Surveillance survey, for 2015) is frequently used across the Global Fund portfolio to inform the design and implementation of effective HIV programs, and to measure results. The OIG’s report states that the falsification of the data misrepresented the grant-funded program’s progress. The OIG proposes that the Secretariat seek recovery of $114,366 in non-compliant expenditures (the total value of the contract to SIDALERTE, the NGO).

5. NEWS

Guinea has faced several significant challenges in implementing its Global Fund grants. Some challenges were inherent to the Global Fund grant policy implementation. Others were related to the country's political and epidemiological contexts. As a low-income country with a weak health system, Guinea needs to spend its co-financing funds optimally. Solutions to most challenges require stronger country ownership and an investment in health systems.

6. NEWS

As of 31 August 2018, overdue agreed management actions were at their lowest level since the Office of the Inspector General started systematically tracking and reporting on the implementation of AMAs in 2014. This information is contained in a progress report prepared for the Board by the OIG and the Secretariat. All AMAs related to three areas – CCM processes, grant closure and risk management – have been closed.

7. NEWS

In the Technical Evaluation and Reference Group’s report to the Global Fund’s 40th Board meeting, TERG Chair Jim Tulloch outlined the group’s main activities for 2019, the processes currently underway in the Prospective Country Evaluations, and an update on thematic reviews, current and future.

8. REPORT

The Health Economics and HIV and AIDS Research Division of the University of Kwazulu-Natal has just published a report synthesizing findings from three country case studies from Eastern and Southern Africa, commissioned by the Bill & Melinda Gates Foundation, as part of its work to support initiatives improving the impact of HIV programmes in the region.

9. NEWS

Of the $98 million approved by the Global Fund Board on 12 November 2018 for 14 country grants from 13 countries, $57.8 million went to countries in the Latin America and Caribbean region. This article repeats some of the overall grant approval information discussed in the first article on grant approvals in this issue, summarizes the LAC grants, and gives some detail on the Grant Approval Committee’s comments about the new grants for Belize, El Salvador, Panama and Paraguay.

10. NEWS

Aidspan is passing on to our readers some information about holiday purchases that can support HIV/AIDS awareness, programmes, and organisations. We make special mention of Product (RED), the ground-breaking private-sector partnership with the Global Fund that has raised more than $500 million so far for Global Fund grants through consumer purchases.

This year’s World Malaria Report delivered a sobering message to the global health community: confirmation that progress in the fight against malaria has stalled, with global malaria cases at around the same level as last year. While many countries are moving quickly towards elimination, “those carrying the highest burden of the disease are losing ground,” a WHO video about the report says.

The report was launched by WHO on 19 November in Maputo, Mozambique, one of the 11 countries identified as bearing around 70% of the global malaria burden.

After years of encouraging results in the global fight against malaria, with global malaria death rates having dropped by 60% since 2000 (the Global Fund calls it “one of the biggest public health successes of the 21st century), the news that gains have, in some places, started to recede has been met with concern. WHO’s Director-General, Dr Tedros Adhanom Ghebreyesus said, in the report, that the disproportionate disease burden carried by several countries, and the inadequate level of investment in malaria control remain particularly worrying.

Of the $3.1 billion in funding for malaria control and elimination in 2017, the Global Fund provided $1.36 billion (44%), and is the largest source of funding for many of the 11 highest-burden countries. PEPFAR provided $1.2 billion (39%), and $900 million came from domestic investments from governments of malaria-endemic countries.

In order to reach the 2030 global health goals, the global malaria response must double by 2020, WHO’s press release for the report launch said.

Some countries have reported impressive progress, including India, Ethiopia, Rwanda and Pakistan, each reporting reductions in the number of malaria deaths between 2016 and 2017. Though their respective approaches have differed, said Dr Pedro Alonso, director of WHO’s Global Malaria Program at a press briefing just before the report’s launch, the common denominator in their success has been effective political leadership galvanizing country-led responses.

“A World Health Organization report released [today] has found that global malaria cases are around the same level as last year, confirming that progress to address the disease has stalled. Rates of malaria are up in high-burden countries, while rates have decreased in other countries due to country-led efforts, the report found. To bring progress back on track to meet global targets, the WHO and partners today announced a new response led by high-burden countries to scale up malaria prevention and treatment.”

“The number of people affected by malaria increased slightly in 2017, a global report has shown, as progress against the disease stalled amid a scaling-down of significant investments.

There were 219 million cases of malaria in 2017, up from 217 million in 2016, according to the “World Malaria Report” released Tuesday by the World Health Organization. It added that 11 countries carry 70 percent of the global burden. Burkina Faso, Cameroon, Democratic Republic of the Congo, Ghana, Mali, Mozambique, Niger, Nigeria, Uganda, Tanzania, and India will now be targeted by a WHO campaign.

“An alarm bell is ringing around the world today: for the second straight year, there is a flatlining of what had been a steady decline in the global malaria epidemic. From 2000 to 2015, the malaria control community had grown accustomed to celebrating the annual reported reduction in cases and deaths. Millions of lives were saved through use of vector control measures, diagnosis, and treatment. Exorbitant health-care costs for many people were averted. Children could attend school instead of a health facility. Breadwinners could keep providing for families. But in the past 2 years, there has been a worrying halt in progress, especially in the highest-burden countries. Both the reduction in cases and levels of investment in treatment and innovations have stalled.”

“The Global Fund joined partners at the launch of the World Malaria Report 2018 with a call to increase investments and renew efforts to accelerate progress in the fight against malaria in high burden countries.”